Objective: The aim of this study was to describe utilization of radiotherapy and treatment compliance in thecontext of Nepal. Methods: A retrospective study was carried out on data collected from the radiotherapytreatment records of patients treated at Manipal Teaching Hospital (MTH), Pokhara, between 28 September2000 and 30 May 2008. Results: In the 944 patients, the gender distribution showed a slight female preponderance(53.7 vs. 46.3%). Curative treatment was given to 62.8% (n=593) and palliative to the remaining 37.2% (n=351).Patients older than 50 years were more likely to receive palliative radiotherapy (p=0.001). The commonestcancers treated were head & neck at 23.7% (n=224), followed by lung at 21.3% (n=201) and cervix at 16.1%(n=152). The majority of patients were between 50-70 years of age (n=564). Nineteen percent (n=179) did notcomplete the prescribed dose of radiation. Unplanned treatment interruptions were found in 35.6% (n=336)and this was not affected by age (p=0.1) or gender (p=0.1). The most frequent treatment interruptioncompromising optimal effectiveness of cancer treatment was observed for head and neck cancers, constituting43% (n=96) of patients in the group. Conclusion: Head and neck in both sexes and cervix in females were themost common cancers treated with a curative intent. Lung cancer, the second most common in both genders,was treated with palliative intent in a large number of cases. This indicates the need for early diagnosis for apossible curative treatment.